Workplace ostracism and employee silence in nursing: the mediating role of organizational identification

To Speak Up or Not to Speak Up, Organisational and Individual Antecedents That Undergird This Behaviour in Resource Constrained Region

AIM

To examine the organisational (i.e., perceived organisational support and psychologically safe environment) and individual (i.e., value, belief and norm) antecedents that strengthen healthcare workers' speaking-up behaviour in a developing economy.

DESIGN

The study uses a cross-sectional design to gather the same data from healthcare workers within the Ashanti Region of Ghana.

METHODS

The data collection happened between 15 June and 30 August 2023. A sample of 380 healthcare workers was selected from 20 facilities in the Ashanti Region of Ghana. A configurational approach, a fussy-set qualitative comparative analysis, was used to identify the configurations that caused high and low speaking-up behaviour among the study sample.

RESULTS

The study results reveal that whereas four configurations generate high speaking-up behaviour, three configurations, by contrast, produce low speaking-up behaviour among healthcare workers.

CONCLUSION

Results suggest that in so far as organisational support systems which take the form of a psychologically safe environment and perceived organisational support are vital in relaxing the hierarchical boundaries in a healthcare setting to improve healthcare workers' speaking-up behaviour, the individual value-based factors that take the form of values, beliefs and norms are indispensable as it provides the healthcare workers with the necessary inner drive to regard speaking-up behaviour on patient safety and care as a moral duty.

IMPACT

Healthcare workers' speaking-up behaviour is better achieved when organisational support systems complement the individual norms, values and beliefs of the individual.

REPORTING METHOD

Adhered to Strengthening Reporting of Observational Studies in Epidemiology guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Echoes of silence

Communication is an integral part of nursing practice-with patients and their relatives, other nurses and members of the healthcare team, and ancillary staff. Through interaction with the 'other', language and silence creates and recreates social realities. Acceptance, rejection or modification of social realities depends on what is expressed and by whom. Narratives that are offered can tell of some experiences and not others. Some nurses choose to be silent while others are silenced. In nursing situations recognising and allowing silence to speak is a challenging but uniquely personal experience that embraces reflection in and on experiences, practice and self as a person and a professional. If enabled and truly heard, silence can speak more loudly than the hubbub of daily practice, allowing us to collectively question and challenge inherent assumptions and biases as professionals, and as a profession. Through a microcosm of Newly Graduated Nurses' lived experiences of nursing situations and expressions of silence individuals' discomfort and private efforts to ascribe meaning to experiences are reflected on. Returning to silence is to return to a constant process of professional transformation that can enable ways of knowing and being that can reform our profession from within and enable us to cast off shackles that bind us to a shameful cultural underbelly.

[Development of the Hospital Nurses' Silence Behavior Scale]

PURPOSE

This study aimed to develop a scale to measure hospital nurses' silence behavior and examine its validity and reliability.

METHODS

A total of 52 preliminary items on hospital nurses' silence behavior were selected using a content validity test by seven experts on 53 candidate items derived from a literature review and in-depth interviews with 14 nurses. A total of 405 hospital nurses participated in a psychometric testing. Data analysis comprised item analysis, exploratory and confirmatory factor analyses, and convergent and discriminant validity tests. Pearson's correlation coefficient was used for assessing concurrent validity, and Cronbach's alpha was used for the reliability test.

RESULTS

The final scale consisted of nine factors with 31 items, exhibiting acceptable model fit indices, convergent validity, and discriminant validity. The score of the entire scale was positively correlated with the 'Organizational Silence Scale (OSS)-the issues on which nurses remain silent' (r = .60, p < .001) and 'OSS-the reasons why nurses remain silent' (r = .68, p < .001). Cronbach's α of the scale was .92, and α of each subscale ranged from .71 to .90.

CONCLUSION

The Hospital Nurses' Silence Behavior Scale is a useful tool for assessing multifaceted silence behavior among nurses. It can provide basic data for developing better communication strategies among nurses and other hospital staff.

Patterns of Ostracism Experienced by Canadian Medical Trainees of Asian Sub-ethnicities

Phenomenon: Ostracism has negative effects on one's fundamental needs. North Americans of Asian ethnicities are at an increased risk of ostracism due to stereotypes labeling them as inherently different to Western cultural norms. We explored Asian Canadian medical trainees' experiences with ostracism during their clinical training. Approach: We conducted semi-structured interviews with 20 medical trainees of Asian ethnicities at 3 Canadian medical schools to explore experiences of ostracism and conducted a thematic analysis guided by the theoretical framework of the temporal need threat model of ostracism. Findings: Participants from East-, South-, and Southeast-Asian sub-ethnic groups completed the study. They voiced experiences of being excluded from clinical and social settings. Ostracism was mainly fueled by systemic racism, power dynamics in medical education, and non-diverse training environments. The model minority myth was a significant contributor to experiences of ostracism. Trainees felt their well-being threatened and many felt resigned to accept ostracism going forward. Insights: Ostracism poses a significant threat to the wellbeing and career progression of Asian Canadian medical trainees. Trainees facing covert ostracism were particularly at risk of entering the resignation stage of hopelessness. This underrecognized problem needs to be addressed by institutions to dismantle harmful stereotypes and prejudiced practices facing these minoritized communities.

Post COVID-19 workplace ostracism and counterproductive behaviors: Moral leadership

BACKGROUND

The wide proliferation of Covid-19 has impacted billions of people all over the world. This catastrophic pandemic outbreak and ostracism at work have posed challenges for all healthcare professionals, especially for nurses, and have led to a significant increase in the workload, several physical and mental problems, and a change in behavior that is more negative and counterproductive. Therefore, leadership behaviors that are moral in nature serve as a trigger and lessen the adverse workplace effects on nurses' conduct.

AIM

this research is directed to explore the impact of post-COVID-19 workplace ostracism on nurses' counterproductive behavior and examine the role of moral leadership as a mediating factor in post-COVID-19 workplace ostracism and nurses' counterproductive behavior.

ETHICAL CONSIDERATION

Ethical review and approval Was received from Ethical Committee at the Faculty of Nursing, Alexandria University, Egypt.

METHODS

A cross-sectional and correlation study was implemented in all units of medical, surgical, critical and intensive care units by using three tools; moral leadership questionnaire, Workplace Ostracism Instrument (WOS), and Counterproductive Work Behaviors Questionnaire (CWBs). A convenient sample of 340 from 699 bedside nurses was granted.

RESULTS

This study revealed that nurses' perceived moderate mean percent (55.49 ± 3.46) of overall workplace ostracism and counterproductive behavior (74.69 ± 6.15). However, they perceived a low mean percentage of moral leadership. There was a significant positive correlation between workplace ostracism and counterproductive behavior. Otherwise, a significant negative correlation was found between moral leadership, workplace ostracism and counterproductive behavior. Also, this study proved the mediating effect of moral leadership in decreasing workplace ostracism by 79.3% and counterproductive behavior by 36.7%.

CONCLUSION

Hospital administrators need to be aware of the significance of moral leadership and apply integrity in the clinical setting to reduce the drawback of isolation on nurses' conduct and increase value for the organization as a whole and nurses in particular.

An integrative systematic review of employee silence and voice in healthcare: what are we really measuring?

The history of inquiries into the failings of medical care have highlighted the critical role of communication and information sharing, meaning that speaking up and employee silence have been extensively researched. However, the accumulated evidence concerning speaking-up interventions in healthcare indicates that they achieve disappointing outcomes because of a professional and organizational culture which is not supportive. Therefore, there is a gap with regard to our understanding of employee voice and silence in healthcare, and the relationship between withholding information and healthcare outcomes (e.g., patient safety, quality of care, worker wellbeing) is complex and differentiated. The following integrative review is aimed at addressing the following questions; (1) How is voice and silence conceptualized and measured in healthcare?; and (2) What is the theoretical background to employee voice and silence?. An integrative systematic literature review of quantitative studies measuring either employee voice or employee silence among healthcare staff published in peer-reviewed journals during 2016-2022 was conducted on the following databases: PubMed, PsycINFO, Scopus, Embase, Cochrane Library, Web of Science, CINAHL and Google Scholar. A narrative synthesis was performed. A review protocol was registered on the PROSPERO register (CRD42022367138). Of the 209 initially identified studies for full-text screening, 76 studies met the inclusion criteria and were selected for the final review (N = 122,009, 69.3% female). The results of the review indicated the following: (1) concepts and measures are heterogenous, (2) there is no unifying theoretical background, and (3) there is a need for further research regarding the distinction between what drives safety voice versus general employee voice, and how both voice and silence can operate in parallel in healthcare. Limitations discussed include high reliance on self-reported data from cross-sectional studies as well as the majority of participants being nurses and female staff. Overall, the reviewed research does not provide sufficient evidence on the links between theory, research and implications for practice, thus limiting how research in the field can better inform practical implications for the healthcare sector. Ultimately, the review highlights a clear need to improve assessment approaches for voice and silence in healthcare, although the best approach to do so cannot yet be established.

Will I speak up or remain silent? Workplace ostracism and employee performance based on self-control perspective

Drawing on the self-control perspective, this study investigated the buffering effect of emotional suppression in reducing the harmful influence of workplace ostracism on employee performance. The research also studied the mediating role of employee silence and voice behaviors based on social exchange theory. We performed moderated mediation analysis on responses received from 159 employees working in the financial industry of the Southern Punjab region of Pakistan. The results showed that workplace ostracism harms employee performance via employee silence and voice behaviors. Furthermore, emotional suppression moderated the mediated relationship between workplace ostracism and employee performance. The results indicated that if ostracized employees adopt voice behavior, emotional suppression cannot aid them in performing better as compared to those who remain silent and regain their self-esteem. Our findings highlight the importance of emotional suppression capability in reducing the damaging outcomes of ostracism in organizational settings.

Workplace ostracism and service performance: The mediating role of job tension, organizational identification, and work engagement

Given the empirical evidence indicating the relationship between workplace ostracism and counterproductive work behavior, this study aims to tackle, in a collectivistic culture, the impact of workplace ostracism on service performance. EFA and CFA were run on the quantitative data collected, online, from 242 respondents. Reliability and validity were assessed. The findings reveal that the relationship between workplace ostracism and service performance is partially mediated by job tension, organizational identification, and work engagement. Organizational identification, in such a collectivistic context, is shown to buffer the negative impact of workplace ostracism on service performance, supporting the results of earlier studies. Different implications are highlighted and recommendations for future research are communicated too.

The Impact of Negative Workplace Gossip on Employees’ Organizational Self-Esteem in a Differential Atmosphere

The level of organizational self-esteem of employees, whether on the production line or as managers or directors of enterprises, does not only correlate with individual performance but has also become a key factor in determining the completion of team core tasks. Based on the theory of self-consistency, this study explores the correlation between negative workplace gossip and employees’ organizational self-esteem by revealing the intermediary role of workplace exclusion and poor-order atmosphere. A survey of 228 employees from enterprises in Shandong and Shanghai showed that negative workplace gossip exerted a significant negative impact on employees’ organizational self-esteem, suggesting that negative workplace gossip reduces employees’ organizational self-esteem in the context of Chinese organizations. In addition, workplace exclusion exerted a complete intermediary effect between negative workplace gossip and employees’ organizational self-esteem, and poor-order atmosphere perception played a partial intermediary role. This study uncovers the black box that negative workplace gossip affects employees’ organizational self-esteem and has a strong enlightening significance for management practice.

Organizational Silence among Hospital Nurses in China: A Cross-Sectional Study

Objective

To analyze the factors that contribute to organizational silence among Chinese nurses.

Methods

A descriptive, comparative, and cross-sectional study was performed with the participation of 866 nurses from public hospitals in China. The data were collected using an online questionnaire that included sociodemographic information and a silence scale.

Results

The overall level of organizational silence among nurses was moderate (51.35 ± 14.99). Nurses indicated that they remained silent about administrative (2.97 ± 1.10) and organizational topics (2.94 ± 1.11) yet were more vocal about matters related to responsibility (1.68 ± 0.86), honor (1.87 ± 0.95), and enthusiasm (2.07 ± 0.99). Moreover, data analysis demonstrated that department, educational status, professional title, years of employment, and employment status had effects on nurses' organizational silence (p < .05).

Conclusion

This study provides information that could facilitate an understanding of organizational silence for both nurses and nursing managers. The results helped to identify the urgent need to adopt effective strategies to address the problem of nurses' organizational silence. Changes in management practices and organizational culture should be implemented to remove communication and other barriers that impede nurses' contributions to their organizations.

Socioeconomic status, ambidextrous learning, and farmers' adoption of biological control technology: evidence from 650 kiwifruit growers in China

BACKGROUND

Rural China is characterized as having different rates of economic growth. The resource and socioeconomic statuses of farm households greatly affect their productivity and the activities they engage in. The main objective in this study was to explore the mechanisms concerning how socioeconomic status of kiwifruit growers affects their adoption of biological control technology (BCT). To achieve this objective, field survey data from 650 kiwifruit farmers in specific kiwifruit growing areas of Shaanxi and Sichuan provinces in China were investigated. The binary probit model and Bootstrap dual mediated utility models served to assess socioeconomic status's effect on farmers' BCT adoption.

RESULTS

This study discovered a significant positive correlation between socioeconomic status and the adoption rate of biological control technology. Farmers of various socioeconomic status have significant differences in the rate of BCT adoption. This study's empirical analysis found that exploratory learning and exploitative learning under dual learning had a significant mediating effect on farmers' socioeconomic status when it came to BCT acceptance.

CONCLUSION

Results show that the rate of BCT adoption is related to farmers' socioeconomic status and dual learning mode, which provides new insights for understanding how farmers implement new technology. This study will help agricultural extension departments increase their awareness of BCT adoption by farmers, and the development of diverse learning approaches in response to differences in socioeconomic status of farmers may significantly increase their likelihood to implement BCT. © 2021 Society of Chemical Industry.

Who is likely to hide knowledge after peer ostracism? An exchange-based perspective of contact quality and need to belong

Purpose

The purpose of this study is to uncover how peer ostracism (POS) elicits knowledge hiding directed towards ostracizing peers through the intervening role of peer contact quality (PCQ). Moreover, the authors aim to highlight the role of the need to belong (NTB) as a first-order boundary condition in direct and indirect hypothesized paths.

Design/methodology/approach

The research opted for a three-wave time-lagged survey design. The data were obtained from the 234 teaching and non-teaching employees working in Higher Educational Sector in Pakistan through random sampling. Mediation and moderated mediation analysis was done by using PROCESS Models 4 and 7.

Findings

The results embraced the mediation, moderation and moderated mediation hypotheses. It was noted that POS creates negative exchange relationships. As a result, the ostracized employees withhold knowledge from the predating peer. NTB served as a buffering agent between POS and PCQ, as well as, in the indirect POS, PCQ and peer-directed knowledge hiding relationship.

Practical implications

This research serves as a guideline for management and faculty of Higher Educational Institutions for minimization of POS to promote effective collegial contact quality and curb knowledge hiding.

Originality/value

Although the research in workplace ostracism and knowledge hiding is not new, yet how this association emerges from the viewpoint of peers is not known. This study has added to the literature by answering who is more likely to reciprocate ostracism from peers by having poor quality contact and directing knowledge hiding towards the predator. By this, the authors have added to the limited stream of moderated mediation mechanisms underlying ostracism and knowledge hiding behaviour. In addition, the authors have drawn attention to the importance of peer relationships in higher educational settings.

Effect of ethical nurse leaders on subordinates during pandemics

BACKGROUND

As caring in times of pandemics becomes extremely stressful, the volume and intensity of nursing work witness significant increase. Ethical practices are therefore even more important for nurses and nurse leaders during this special period.

RESEARCH AIM

The aim was to explore the relationship between ethical nurse leaders and nurses' task mastery and ostracism, and to examine the mediating role of relational identification in this relationship during pandemics.

RESEARCH DESIGN

Based on social exchange theory, this study tests a theoretical model proposing that ethical nurse leaders can increase nurses' task mastery and reduce their ostracism by improving their relational identification with leaders during pandemics.

PARTICIPANTS AND RESEARCH CONTEXT

A multilevel and multi-wave field study using data from 172 nurses from 45 departments of two comprehensive hospitals was performed from April to August 2020 to test proposed hypotheses.

ETHICAL CONSIDERATIONS

We received formal approvals from the ethical committee of the hospital where we conducted this study before the data collection.

RESULTS

Ethical nurse leaders can indeed increase nurses' task mastery and reduce their ostracism during the pandemic period; furthermore, nurses' identification with their leaders mediates these relationships. We find that ethical leadership plays an even more important role in improving nurses' task mastery and reducing their ostracism that may be facilitated by pandemics this special time. Nurses will become more identified with their leaders when they are treated by ethical ways.

DISCUSSION

The study tries to advance our understanding of the important role of ethical leadership in nurse management literature and provide useful suggestions for healthcare institutions, nurse leaders, and nurses during pandemics.

CONCLUSION

Theoretical contributions and practical implications of our findings are discussed. Specifically, we suggest that healthcare institutions cultivate ethical nurse leaders to facilitate nurses' relational identification, which in turn will positively influence work outcomes.

Consequences of Workplace Ostracism: A Meta-Analytic Review

Workplace ostracism, which is regarded as “social death,” is rampant in organizations and has attracted significant research attention. We extend the understanding of workplace ostracism by conducting a meta-analysis of studies of the relationships between workplace ostracism and its consequences. We also explore the moderating effects of national culture (i.e., collectivism vs. individualism) and the mediating effects of organization-based self-esteem (OBSE). The results of a meta-analysis of 95 independent samples (N = 26,767) reveal that exposure to workplace ostracism is significantly related to individuals’ attitudes, well-beings, and behaviors. Moreover, the effects of workplace ostracism on belongingness, job satisfaction, emotional exhaustion, organizational citizenship behavior (OCB) toward individuals (OCBI), organizational deviance, and interpersonal deviance are stronger in individualist contexts than in collectivist contexts. However, the relationships between workplace ostracism and organizational identification and OCB are stronger in collectivist contexts than in individualist contexts. Our meta-analytical structural equation modeling also provides evidence of the mediating effects of OBSE on the relationships between workplace ostracism and organizational commitment, job satisfaction, and job performance. The implications and limitations of our study and future research directions are also discussed.

Nursing practice environment and employee silence about patient safety: The mediating role of professional discrimination experienced by nurses

AIMS

To examine the associations between nurse work environment with nurses' silence about patient safety and the mediating effects of professional discrimination experienced by nurses.

DESIGN

Multicentre cross-sectional study.

METHODS

Between January and April 2019, 607 nurses and nursing assistants from seven hospitals in Greece assessed their clinical environment using the 'Practice Environment Scale of the Nursing Work Index Revised-PES-NWIR', and the silence about patient safety. The 'Experiences of Discrimination Index' was adapted to specifically address experienced discrimination based on the nursing profession. The PROCESS macros for SPSS were used to examine the above associations.

FINDINGS

Better nurse practice environment, with the exception of 'staffing and resource adequacy' dimension, was directly associated with less experienced professional discrimination, and directly and indirectly associated with less silence about patient safety, through the mediating role of professional discrimination experienced by nurses.

CONCLUSIONS

Silence about patient safety is dependent on the clinical work environment and may be a response of nurses to discrimination in the work context. Both an improvement in the nurse work environment and a decrease in professional discrimination would minimize silence about patient safety.

IMPACT

On many occasions, nurses are directly or indirectly discouraged from voicing their concerns about patient safety or are ignored when they do, leading to employee silence and decreasing the standard of care (Alingh et al., BMJ Quality & Safety, 2019, 28, 39; Pope, Journal of Change Management, 2019, 19, 45). Nurses' work-related determinants for silence are not clearly understood in the patient safety context. A favourably evaluated nurse practice environment is associated with less experienced professional discrimination and less silence about patient safety. To minimize silence about patient safety, both the nurse work environment and the experienced professional discrimination should be taken into consideration by nurse and healthcare managers.

The mediating effect of interpersonal distrust on the relationship between perceived organizational politics and workplace ostracism in higher education institutions

Despite a widespread consensus towards the implications of workplace ostracism to employees, little research attention has been paid to exploring its determinants, especially in the educational sector. In the context of higher education institutions, workplace ostracism can lead to a number of undesired outcomes, such as deviant workplace behavior, turnover, and decreased job performance. Thus, this study aims to explore the role of perceived organizational politics in promoting workplace ostracism. Drawing on the social exchange theory, the study also attempts to identify the mediating role of interpersonal distrust in the relationship between perceived organizational politics and workplace ostracism in higher education institutions. Data were conveniently collected from 154 full-time faculty members serving in five public universities in Bangladesh. To test the research hypotheses, the study employed partial least squares path modeling. The findings revealed that there is a significant positive association between perceived organizational politics and workplace ostracism and that interpersonal distrust plays an intervening role in the relationship. These results highlight the role of perceived organizational politics and interpersonal distrust in shaping academics’ workplace ostracism. Based on the findings, the study suggests both practical and theoretical implications with directions for future research.

Impact of organizational silence and favoritism on nurse's work outcomes and psychological well-being

OBJECTIVES

The study aimed to assess the impacts of organizational silence and favoritism on work outcomes and psychological wellbeing among nurses working in hospitals.

BACKGROUND

Literature on the organizational climate among nurses in hospital settings is limited, particularly on favoritism and organizational silence and their effect on nurses.

METHODS

Purposive sampling was used to gather 549 registered nurses who participated in this cross-sectional study. Standardized self-report questionnaires were used to gather the necessary data.

RESULTS

Years in the nursing profession (β = .028, P < .001), location of work (β = 0.481, P < .001), and facility size (β = 0.451, P < .001) strongly predicted organizational silence, while years in the present unit (β = 0.020, P = .022) and last shift length (β = 0.200, P = .012) predicted favoritism. Favoritism (β = 0.226, P = .028) significantly influenced turnover intention in nurses.

CONCLUSION

Higher levels of favoritism within the organization are strongly linked with nurses' turnover intention. Few individual and organizational variables predicted organizational silence and favoritism.

IMPLICATIONS TO NURSING MANAGEMENT

The results of this study provide an insight to the effects of organizational silence and favoritism towards nurses' work outcomes and psychological wellbeing. Improving the channels of communication among the healthcare team is vital to promote inclusivity among healthcare workers and enhance organizational viability.

Workplace Ostracism in Nurses and Its Determining Factors

AIM AND OBJECTIVES

This study attempted to identify workplace ostracism in nurses and its determining factors.

BACKGROUND

Ostracism, which is a form of mistreatment in the nursing workplace, is neglected in the nursing profession although it can affect the quality of healthcare services.

DESIGN

The present study was a descriptive correlational study.

METHODS

Nurses in healthcare centers (n = 340) that had at least 12 months of clinical care experience were selected through proportionate stratified random sampling for the period from 2018 to 2019. The study instruments were a modified questionnaire based on the workplace ostracism scale and a questionnaire that assessed personal-social factors. To analyze the data, descriptive and inferential statistics were used.

RESULTS

Participants' average ostracism score was 9.03 ± 36.63, and there were statistically significant relationships between ostracism and employment status, university of education, a record of getting an incentive, nurses' current physical disorders, and feelings of colleagues' envy and managers' discrimination.

CONCLUSIONS

Applying some approaches to educate nurses about interpersonal relationships and clearly communicating mutual expectations between the staff and nursing management could help solve this problem.

IMPLICATIONS FOR PRACTICE

The study results will serve to guide legislators and managers in developing interventions to create supportive and safe work environments, both for nurses and patients.

The Mediating Effect of Perceived Stress and Moderating Effect of Trust for the Relationship Between Employee Silence and Behavioral Outcomes

Employees withholding their opinions is pervasive in organizations. However, the individual outcomes of employee silence have not been frequently investigated. Previous studies have found that there are detrimental effects of employee silence and building on this research stream, the study viewed perceived stress as an underlying mechanism linking employee silence to task performance and deviant behavior. Moreover, this study explored the moderating effect of interpersonal trust in the relationship between employee silence and perceived stress. Using a sample of 231 white-collar employees from China, this study found perceived stress to mediate the relationships between employee silence and task performance and deviant behavior. Also, coworker trust was found to moderate the relationship between employee silence and perceived stress. As coworker trust moderated the relationship, supplementary analyses further found mediated moderation for the model.

Insights of Silence

Silence represents more than the absence of noise; it is a penetrating stillness that often provides for attentiveness. The author of this article provides some thoughts and implications for the art of humanbecoming on what can be gleaned in understanding and clarifying the discriminating quiet or tumultuous hush of silence as a human experience.

Effect of workplace ostracism on emotional exhaustion and unethical behaviour among Chinese nurses: A time-lagged three-wave survey

AIM

This study examined the following: (a) the impact of nurses' workplace ostracism on unethical behaviour; (b) mediating role of emotional exhaustion between nurses' workplace ostracism and unethical behaviour; and (c) moderating effect of hostile attribution bias.

BACKGROUND

While unethical behaviour is a workplace phenomenon that can negatively influence the sustainable development of settings, few nurse studies have explored it. This study identified an interpersonal antecedent of unethical behaviour: workplace ostracism.

DESIGN

A time-lagged three-wave survey was conducted over 3 months (November 2016-January 2017) to collect data.

METHODS

Nurses (N = 530) from three hospitals in China completed three anonymous self-reported questionnaires. Descriptive statistics, linear regression, and moderated mediation tests were performed, and data analysed using SPSS 23.0 and Mplus7.4.

RESULTS

Workplace ostracism positively influenced nurses' unethical behaviour and emotional exhaustion mediated the relationship between workplace ostracism and unethical behaviour. Nurses' hostile attribution bias moderated the effect of workplace ostracism on emotional exhaustion and unethical behaviour.

CONCLUSION

Workplace ostracism was an important interpersonal factor predicting unethical behaviour. Nurse supervisors should establish a harmonious interpersonal environment and be aware of hostile attribution bias to prevent nurses' unethical behaviour.

IMPACT

Workplace ostracism is a pervasive phenomenon in the nursing workplace that contributes to unethical behaviour. Nurse supervisors and staff should together establish harmonious working environments without workplace ostracism. Nurse supervisors should pay attention to nurses' emotions and conduct psychological counselling to minimize the negative effects of workplace ostracism. This study contributed to understanding how and why nurses engaged in unethical behaviour.

Development and psychometric testing of the Organizational Silence Behavior Scale for healthcare professionals

Organizational silence maintained by professionals working in the healthcare sector could result in various moral dilemmas and might negatively affect patient care. The aim of this methodological study was to develop a scale that measured the organizational silence behaviors of healthcare professionals. During the development of the scale, researchers conducted in-depth interviews with 30 healthcare professionals in order to create a draft pool of 66 scale items. After content validity, a 62 item scale was drafted. In the second stage of development, psychometric properties of the scale were evaluated. The results of the confirmatory factor analysis indicated that adequate fit indices (χ² value to degrees of freedom = 3.54; goodness-of-fit index = .92; root mean square error of approximation = .90) were achieved and resulted in a 32 item scale with four subscales. These subscales were assessed using a 5 point Likert scale. The Cronbach's alpha for the scale was .93, and for the subscales, it was as follows: silence climate: α = .91, silence based on fear: = .91, acquiesce silence: α = .93, and silence based on protecting the organization: α = .85. The Organizational Silence Behavior Scale was successfully developed and showed satisfactory validity and reliability. It is usable among healthcare professionals.

Walking the Plank: An Experimental Paradigm to Investigate Safety Voice

The investigation of people raising or withholding safety concerns, termed safety voice, has relied on report-based methodologies, with few experiments. Generalisable findings have been limited because: the behavioural nature of safety voice is rarely operationalised; the reliance on memory and recall has well-established biases; and determining causality requires experimentation. Across three studies, we introduce, evaluate and make available the first experimental paradigm for studying safety voice: the “Walking the plank” paradigm. This paradigm presents participants with an apparent hazard (walking across a weak wooden plank) to elicit safety voice behaviours, and it addresses the methodological shortfalls of report-based methodologies. Study 1 (n = 129) demonstrated that the paradigm can elicit observable safety voice behaviours in a safe, controlled and randomised laboratory environment. Study 2 (n = 69) indicated it is possible to elicit safety silence for a single hazard when safety concerns are assessed and alternative ways to address the hazard are absent. Study 3 (n = 75) revealed that manipulating risk perceptions results in changes to safety voice behaviours. We propose a distinction between two independent dimensions (concerned-unconcerned and voice-silence) which yields a 2 × 2 safety voice typology. Demonstrating the need for experimental investigations of safety voice, the results found a consistent mismatch between self-reported and observed safety voice. The discussion examines insights on conceptualising and operationalising safety voice behaviours in relationship to safety concerns, and suggests new areas for research: replicating empirical studies, understanding the behavioural nature of safety voice, clarifying the personal relevance of physical harm, and integrating safety voice with other harm-prevention behaviours. Our article adds to the conceptual strength of the safety voice literature and provides a methodology and typology for experimentally examining people raising safety concerns.

Relationship Between Workplace Ostracism and Unsafe Behaviors: The Mediating Effect of Psychological Detachment and Emotional Exhaustion

This research tests whether the stressor-detachment model can explain the mechanism between workplace ostracism and employees’ unsafe behaviors. We used a self-report questionnaire to assess Chinese construction workers’ workplace ostracism, psychological detachment, emotional exhaustion, and unsafe behaviors. In total, 349 valid questionnaires were collected. We used cross-sectional structural equation modeling to assess our conceptual model. The results indicate that workplace ostracism has a significant effect on psychological detachment and emotional exhaustion and thus affects employees’ unsafe behaviors. In addition, workplace ostracism could influence employees’ unsafe behaviors through the sequential combination of psychological detachment and emotional exhaustion. Moreover, psychological detachment mediates the relationship between workplace ostracism and emotional exhaustion. Taken together, our findings extend the application of the stressor-detachment model by revealing how workplace ostracism influences employees’ unsafe behaviors.

The Influence of Supportive and Ethical Work Environments on Work-Related Accidents, Injuries, and Serious Psychological Distress among Hospital Nurses

The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers' compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. Self-reported questionnaires were distributed to nurses (n = 1114) from 11 hospitals. Valid responses (n = 822, 93% women, mean age = 38.49 ± 10.09 years) were used for analyses. The questionnaire included items addressing basic attributes, work and organizational characteristics, social capital and ethical climate at the workplace, psychological distress, and experience of work-related accidents or injuries in the last half year. The final model of a multivariate logistic regression analysis revealed that those who work less than 4 h of overtime per week (OR = 0.313), those who work on days off more than once per month (OR = 0.424), and an exclusive workplace climate (OR = 1.314) were significantly associated with work-related accidents or injuries. Additionally, an exclusive workplace climate (OR = 1.696) elevated the risk of serious psychological distress. To prevent work-related compensation cases, which are caused by these variables, strengthening hospitals' occupational health and safety is necessary.